MPD oversight board recommends nixing ‘outdated training’ on excited delirium

A Minneapolis police oversight board has recommended the police department replace what the board calls “outdated training” about excited delirium, a controversial medical diagnosis that police say can give people “superhuman” strength. 

The diagnosis has not been recognized by the American Medical Association, the American Psychiatric Association or World Health Organization, but has been widely used by police to justify force and explain deaths of people in custody. 

The attorney for Derek Chauvin, who restrained George Floyd until he died, suggested Floyd had excited delirium, while Minneapolis police have also cited excited delirium to get paramedics to inject people with the powerful anesthetic ketamine. 

Dr. Nicholas Simpson, chief medical director at Hennepin EMS, told the Minneapolis Police Conduct Oversight Commission earlier this month that Hennepin EMS and the Hennepin Healthcare System are no longer using “excited delirium” in their practice and education. Hennepin EMS physicians have been revising medical training materials for law enforcement officers, including the Minneapolis Police Department. 

“It has become increasingly clear that excited delirium syndrome has become associated with a strong bias and to many groups it is a very triggering term. It is not a helpful term anymore” Simpson told the commission, which analyzes data and policies to provide advice to the mayor and city council.

Simpson said they want to get away from “lumping everybody into this worst-case scenario” diagnosis even though it’s virtually impossible to “de-escalate verbally” some people without medical intervention.

People exerting themselves can experience a chemical imbalance and lose the mechanism that forces their body to rest, Simpson said, which ”can be quite dangerous.” It can be very difficult to resuscitate them, and so if they are restrained, that can make it worse and lead to death, he said.

Abigail Cerra, chair of the PCOC, wrote to Mayor Jacob Frey and Police Chief Medaria Arradondo recommending that MPD re-educate officers on the issue, especially given the city will be hiring more than 100 police officers in 2022. 

The mayor’s office released a statement in response saying the physician working with MPD training staff has not used the term “excited delirium” in accordance with the June 2021 policy adopted by the AMA. The most recent fall 2021 training of all MPD members did not include the term and emphasizes identifying altered mental status as a potentially serious medical emergency and obtaining EMS assistance as soon as possible.

Cerra said the officers need new training to debunk the misinformation they received in the past, and they could benefit from additional, medically sound training on what can cause erratic behavior and what to do until mental health professionals or paramedics are. She also thinks they need retraining on the risks associated with some of their restraint techniques.

PCOC Commissioner John Sylvester, who also works for Hennepin EMS, told the PCOC he’s seen a significant increase in calls by law enforcement officers for paramedics “just in case.” He said that’s a good thing and they want police to “call early and often” since EMS workers are better equipped to treat people in medical crisis. 

The mayor’s office released a statement saying it has received the PCOC  recommendations and are reviewing them as part of work already underway on the topics. 

Misconduct investigations

The PCOC also recommended the MPD continue misconduct investigations even after officers leave the department. 

Currently, internal affairs — which investigates complaints with the Office of Police Conduct Review — closes investigations if the officer leaves their job. Those records never become public since under state law, only cases in which discipline is upheld are public. 

Cerra said there should be a record of misconduct in case the officer returns or goes to another city. She can see why the department would not want to “waste resources” on such investigations, but she cited the recent Jaleel Stallings case as an example where  three officers accused of “egregious misconduct” left MPD before a misconduct investigation was done.

“Those officers could come back; they could join other law enforcement agencies,” she said. “That was so shocking to me… I think it’s an important lesson and important takeaway.” 

The PCOC voted to recommend that open investigations should continue.

A spokeswoman for Frey’s office said they have been in conversations for several weeks with city attorneys about the practice of investigating allegations of officer misconduct after an officer has left the department. 

Updated at 8 p.m. Thursday to include a response from the mayor’s office and at 12:34 p.m. Monday to correct a reference to HHS.